Cystic mesothelioma of the peritoneum

Our plain-English summary of Cystic mesothelioma of the peritoneum, by J.D. O'Neil, P.R. Ros, B.L. Storm, et al (Radiology, 1989).

The study

• Authors: J.D. O'Neil, P.R. Ros, B.L. Storm, J.L. Buck, E.J. Wilkinson
• Journal: Radiology
• Published: 1989;170(2):333-7
• Cited by: 69 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Cystic mesothelioma (CM) of the peritoneum is a rare, benign neoplasm that occurs predominantly in women and tends to recur locally. It has received little attention (to our knowledge, a single case report) in the radiology literature. Five cases of CM are presented. Computed tomography (CT) was performed in three cases, ultrasound (US) in four cases, and magnetic resonance (MR) imaging in one case. Twenty-eight cases reported in the literature are reviewed for comparison. CM shows a clear predilection for the surfaces of the pelvic viscera but is seen in other areas of the peritoneum and retroperitoneum. The neoplasm was intraperitoneal in three cases and primarily retroperitoneal in the other two cases. In all CT and US studies performed, a single large, multilocular cystic mass was demonstrated. MR imaging, performed in one case, showed that the lesion had signal characteristics typical of a watery collection low in solute concentration. It is concluded that CM of the peritoneum has a nonspecific multilocular cystic appearance on images, which does not permit it to be differentiated from other cystic lesions.

In plain English

This article was a case series describing five patients with cystic mesothelioma of the peritoneum. The authors called it a rare, benign tumor and contrasted it with malignant peritoneal mesothelioma. The patients were three women and two men aged 26 to 54, collected over a 5-year period. The authors also reviewed 28 published cases, of which 25 (89%) occurred in women. Ultrasound in four patients and CT in three patients showed masses made up of many cysts. MR imaging in one patient showed fluid with signals similar to urine. Abdominal pain was the most common symptom (four of five patients). One patient's tumor recurred at 16 months. The authors judged that a second patient's earlier mass, diagnosed as lymphangioma, was likely the same tumor, giving a 40% recurrence rate in their series. The article noted asbestos exposure in one case, without saying which, and stated that a cause-and-effect link between asbestos and this tumor has not been established. The authors concluded that the tumor looks nonspecific on scans and cannot be told apart from other cystic lesions.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Case series of five patients, with a review of 28 cases from the published literature
• Who was studied: Five patients with cystic mesothelioma of the peritoneum, collected over a 5-year period: three women and two men aged 26 to 54 (mean 35.6 years). The article does not give the dates. It also reviewed 28 cases previously described in the literature.
• Exposure: This was not a study of asbestos exposure. It studied the imaging appearance of the tumor: ultrasound in four cases, CT in three, and MR imaging in one. The article mentions asbestos exposure in one case but gives no fiber type, source or dose, and does not make clear whether that case was one of the five patients or a reviewed case.
• Main results:
  • Abdominal pain was the most common presenting symptom in the five patients (four of five cases).
  • All four patients who had ultrasound showed a large multicystic mass. CT showed multilocular cystic masses in all three patients scanned.
  • On MR imaging in one patient (case 1), the signal of the lesions was similar to that of urine in the bladder.
  • Case 1 recurred at 16 months. The authors considered that case 2's mass, removed 9 years earlier and diagnosed as lymphangioma, was likely cystic mesothelioma, making the recurrence rate in their series 40%.
  • Of the 28 reviewed literature cases, 25 (89%) occurred in women, with a mean age of 37.8 years.
  • Asbestos exposure was present in one case. The authors stated that a cause-and-effect relationship between asbestos exposure and this tumor has not been established.
• The authors' conclusion: The authors concluded that cystic mesothelioma of the peritoneum has a nonspecific multilocular cystic appearance on images, which does not allow it to be differentiated from other cystic lesions. They also wrote that CT is probably the preoperative imaging method of choice.
• Limitations the authors state:
  • Preoperative images were available for only six of the 28 literature cases, so comparisons with those cases rest mainly on clinical and pathologic descriptions.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma, Peritoneal mesothelioma.

Medical terms in this study, explained in our Lexicon: Mesothelioma, Peritoneum, Neoplasm, Ultrasound, Retroperitoneum.

Related studies

• Benign cystic peritoneal mesothelioma — J.A. Schneider, E.J. Zelnick (1985)
• Benign cystic mesothelioma of the peritoneum--a case report — Y.L. Suh, W.J. Choi (1989)
• Benign cystic mesothelioma of the peritoneum in a child-case report and review of the literature — V.C. Shakya, C.S. Agrawal, et al. (2011)
• Giant benign cystic peritoneal mesothelioma: US, CT, and MRI findings — A. Ozgen, D. Akata, et al. (1998)
• Cystic mesothelioma of the peritoneum. A report of three cases — S. Villaschi, F. Autelitano, et al. (1990)
• Benign cystic mesothelioma of the peritoneum in a male child — Z. Stojsic, R. Jankovic, et al. (2012)

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